A unique episode of REM sleep behavior disorder triggered during surgery for Parkinson's disease

REM sleep behavior disorder (RBD) is characterized by vigorous movements during REM sleep. Here, the authors report the case of a patient who presented such a disorder immediately after the implantation of the definitive electrode for left subthalamic stimulation. Interestingly, this was and has remained a unique episode in his medical history. It was found that a microlesion in or near the upper part of the pars compacta of the substantia nigra was very likely responsible for this phenomenon.